U.S. patent number 7,951,068 [Application Number 11/888,069] was granted by the patent office on 2011-05-31 for rotating self-traveling endoscope system, rotating self-traveling endoscope insertion assisting tool, and method for technique of inserting endoscope insertion portion into small intestine using rotating self-traveling endoscope system.
This patent grant is currently assigned to Olympus Medical Systems Corporation. Invention is credited to Yasuhito Kura.
United States Patent |
7,951,068 |
Kura |
May 31, 2011 |
Rotating self-traveling endoscope system, rotating self-traveling
endoscope insertion assisting tool, and method for technique of
inserting endoscope insertion portion into small intestine using
rotating self-traveling endoscope system
Abstract
A rotating self-traveling endoscope system of the invention
comprising an insertion portion having an image pickup unit at its
distal end portion and a helical structure formed on the outer
surface, a rotating driving device for rotating the insertion
portion around a long axis, and a rotating self-traveling insertion
assisting tool through which the insertion portion can be freely
inserted and which is provided with a flexible tube having a
bending portion disposed therein is capable of passage of the
insertion portion through a space in a body cavity and passage
through a valve in the body cavity, which improves insertion
performance into a small intestine.
Inventors: |
Kura; Yasuhito (Hachioji,
JP) |
Assignee: |
Olympus Medical Systems
Corporation (Tokyo, JP)
|
Family
ID: |
39030104 |
Appl.
No.: |
11/888,069 |
Filed: |
July 31, 2007 |
Prior Publication Data
|
|
|
|
Document
Identifier |
Publication Date |
|
US 20080033245 A1 |
Feb 7, 2008 |
|
Foreign Application Priority Data
|
|
|
|
|
Aug 3, 2006 [JP] |
|
|
2006-212557 |
|
Current U.S.
Class: |
600/114; 600/118;
600/115; 600/117; 600/137 |
Current CPC
Class: |
A61B
1/0052 (20130101); A61B 1/0055 (20130101); A61B
1/00071 (20130101); A61B 1/0016 (20130101); A61B
1/015 (20130101) |
Current International
Class: |
A61B
1/00 (20060101) |
Field of
Search: |
;600/104,106-107,114-115,121-123,137 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
2000-225092 |
|
Aug 2000 |
|
JP |
|
2006-034627 |
|
Feb 2006 |
|
JP |
|
Primary Examiner: Kasztejna; Matthew J
Attorney, Agent or Firm: Scully, Scott, Murphy &
Presser, P.C.
Claims
What is claimed is:
1. A rotating self-traveling endoscope system comprising: an
insertion portion having an image pickup unit provided at a distal
end portion of the insertion portion and a helical structure formed
on an outer surface of the insertion portion, the insertion portion
being configured to rotatably advance in a longitudinal axis
direction thereof; a rotating driving device for rotating the
insertion portion around the longitudinal axis thereof; a flexible
tube having a lumen through which the insertion portion is
rotatably advanced; a bending portion disposed continuously at a
distal end side of the flexible tube, the bending portion being
configured to bend in an instructed direction; and a protecting
member having flexibility and inserted through the lumen of the
flexible tube, for separating the helical structure of the
insertion portion from an inner surface of the flexible tube,
wherein the protecting member has an entire length not reaching the
bending portion in a state of being inserted through the lumen of
the flexible tube so as to prevent a bending mobility of the
bending portion from being undermined.
2. The rotating self-traveling endoscope system according to claim
1, wherein the flexible tube is provided with a thrust generating
member which is capable of detachable attachment, holds the helical
structure of the insertion portion in pressure contact and
generates a thrust.
3. The rotating self-traveling endoscope system according to claim
2, further comprising a protecting member covering the insertion
portion and inserted through the flexible tube together with the
insertion portion.
4. The rotating self-traveling endoscope system according to claim
3, wherein the protecting member has a length not reaching inside
of the bending portion in the state inserted through the flexible
tube.
5. The rotating self-traveling endoscope system according to claim
1, further comprising: a distal-end rigid portion disposed
continuously at a distal end side of the bending portion and having
a distal end opening from which the insertion portion is guided
out; and a thrust generating member provided at the distal-end
rigid portion, the thrust generating member being in pressure
contact with the helical structure to assist advancement and
retreat of the insertion portion.
6. The rotating self-traveling endoscope system according to claim
1, further comprising a thrust generating member provided at the
protecting member, the thrust generating member being in pressure
contact with the helical structure to assist advancement and
retreat of the insertion portion.
7. The rotating self-traveling endoscope system according to claim
1, further comprising a housing case adapted to house the insertion
portion between the rotating driving device and the flexible
tube.
8. The rotating self-traveling endoscope system according to claim
7, wherein the protecting member is connected to the housing case.
Description
This application claims benefit of Japanese Application No.
2006-212557 filed on Aug. 3, 2006 the contents of which are
incorporated by this reference.
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to an endoscope which self-travels in
a body cavity while rotating around an insertion direction, a
self-traveling endoscope system to be externally inserted into an
insertion portion of the endoscope for improving insertion
performance of the insertion portion into the body cavity and
particularly into a small intestine, a rotating self-traveling
endoscope insertion assisting tool which assists insertion of the
endoscope, and a method for technique of inserting the endoscope
insertion portion into the small intestine using the rotating
self-traveling endoscope system.
2. Description of the Related Art
Conventionally, a medical endoscope has been used by being inserted
into a body cavity for endoscopic inspections. Various proposals
have been made for this type of endoscope for easy insertion into a
bent lumen such as a colon, which is a body cavity.
Japanese Unexamined Patent Application Publication No. 2006-34627
discloses provision of a helical structure on an outer
circumferential surface of an endoscope and a technique for
assisting insertion of the endoscope into a body cavity by a thrust
by rotation applied by an endoscope insertion assisting device, for
example.
Also, Japanese Unexamined Patent Application Publication No.
2000-225092 discloses a self-traveling colon endoscope advance
assisting tool which can smoothly insert a self-traveling endoscope
into a colon by an anus inserting tube.
SUMMARY OF THE INVENTION
A rotating self-traveling endoscope system of the present invention
comprises an insertion portion having an image pickup unit provided
at a distal end portion and a helical structure formed on the outer
surface, a rotating driving device for rotating the insertion
portion around a long axis, and a rotating self-traveling endoscope
insertion assisting tool through which the insertion portion can be
freely inserted and which is provided with a flexible tube having a
bending portion disposed therein.
The rotating self-traveling endoscope assisting tool of the present
invention also comprises the bending portion capable of bending at
least in two directions, the flexible tube continuously provided at
the bending portion and provided with flexibility through which the
insertion portion of the rotating self-traveling endoscope can be
freely inserted, and an operation portion for bending and operating
the bending portion.
Moreover, a first method for technique of inserting the endoscope
insertion portion into a small intestine using the rotating
self-traveling endoscope system is carried out by using the
rotating self-traveling endoscope system provided with an insertion
portion having an image pickup unit at the distal end portion and a
helical structure formed on the outer surface, a rotating driving
device for rotating the insertion portion around a long axis, and a
rotating self-traveling endoscope insertion assisting tool through
which the insertion portion can be freely inserted and which is
provided with a flexible tube with a bending portion disposed, and
the distal end portion of the flexible tube is inserted into a
duodenum from an oral cavity via a gaster by angle operation of the
bending portion, the rotating driving device is driven so as to
rotate the insertion portion around the long axis and to generate a
thrust by contact between the intestinal wall of the duodenum and
the helical structure and the insertion portion is advanced into
the deep portion of a small intestine.
Also, a second method for technique of inserting the endoscope
insertion portion into the small intestine using the rotating
self-traveling endoscope system is carried out by using the
rotating self-traveling endoscope system provided with an insertion
portion having an image pickup unit at the distal end portion and a
helical structure formed on the outer surface, a rotating driving
device for rotating the insertion portion around a long axis, and a
rotating self-traveling endoscope insertion assisting tool through
which the insertion portion can be freely inserted and which is
provided with a flexible tube with a bending portion disposed, and
the distal end portion is inserted into a colon from an anus, the
rotating driving device is driven so as to rotate the insertion
portion around the long axis and to generate a thrust by contact
between the intestinal wall of the colon and the helical structure,
the insertion portion is advanced into the vicinity of a cecum, the
distal end portion of the flexible tube is inserted into an ileum
by an angle operation of the bending portion so that the Bauhin
valve of ileocecum portion is passed, and the rotating driving
device is driven again so as to rotate the insertion portion around
the long axis and to generate the thrust by contact between the
intestinal wall of the ileum and the helical structure so that the
insertion portion is advanced into the deep portion of a small
intestine.
The above and other objects, features and advantages of the
invention will become more clearly understood from the following
description referring to the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is an entire block diagram illustrating a rotating
self-traveling endoscope system according to an embodiment of the
present invention;
FIG. 2 is a perspective view illustrating a distal end portion of
an over tube through which the rotating self-traveling endoscope
according to the embodiment of the present invention is
inserted;
FIG. 3 is a sectional view illustrating the distal end portion of
the over tube through which the rotating self-traveling endoscope
in the state of FIG. 2 is inserted according to the embodiment of
the present invention;
FIG. 4 is a sectional view for explaining a thrust generating cap
disposed at the distal end portion of the over tube according to
the embodiment of the present invention;
FIG. 5 is a perspective view illustrating the thrust generating cap
according to the embodiment of the present invention;
FIG. 6 is a perspective view illustrating the thrust generating cap
of a first variation according to the embodiment of the present
invention;
FIG. 7 is a perspective view illustrating the thrust generating cap
of a second variation according to the embodiment of the present
invention;
FIG. 8 is an entire block diagram illustrating a rotating
self-traveling endoscope showing a variation according to the
embodiment of the present invention;
FIG. 9 is a plan view illustrating a length relation between the
over tube and a cover tube according to the embodiment of the
present invention;
FIG. 10 is a first view for explaining an action showing an example
of a technique for inserting the rotating self-traveling endoscope
into a small intestine via the over tube according to the
embodiment of the present invention from an oral cavity;
FIG. 11 is a second view for explaining an action showing an
example of a technique for inserting the rotating self-traveling
endoscope into a small intestine via the over tube according to the
embodiment of the present invention from an oral cavity;
FIG. 12 is a third view for explaining an action showing an example
of a technique for inserting the rotating self-traveling endoscope
into a small intestine via the over tube according to the
embodiment of the present invention from an oral cavity;
FIG. 13 is a fourth view for explaining an action showing an
example of a technique for inserting the rotating self-traveling
endoscope into a small intestine via the over tube according to the
embodiment of the present invention from an oral cavity;
FIG. 14 is a fifth view for explaining an action showing an example
of a technique for inserting the rotating self-traveling endoscope
into a small intestine via the over tube according to the
embodiment of the present invention from an oral cavity;
FIG. 15 is a sixth view for explaining an action showing an example
of a technique for inserting the rotating self-traveling endoscope
into a small intestine via the over tube according to the
embodiment of the present invention from an oral cavity;
FIG. 16 is a seventh view for explaining an action showing an
example of a technique for inserting the rotating self-traveling
endoscope into a small intestine via the over tube according to the
embodiment of the present invention from an oral cavity;
FIG. 17 is a first view for explaining an action showing an example
of a technique for inserting the rotating self-traveling endoscope
into a small intestine via the over tube according to the
embodiment of the present invention from an anus;
FIG. 18 is a second view for explaining an action showing an
example of a technique for inserting the rotating self-traveling
endoscope into a small intestine via the over tube according to the
embodiment of the present invention from an anus;
FIG. 19 is a third view for explaining an action showing an example
of a technique for inserting the rotating self-traveling endoscope
into a small intestine via the over tube according to the
embodiment of the present invention from an anus;
FIG. 20 is a fourth view for explaining an action showing an
example of a technique for inserting the rotating self-traveling
endoscope into a small intestine via the over tube according to the
embodiment of the present invention from an anus;
FIG. 21 is a fifth view for explaining an action showing an example
of a technique for inserting the rotating self-traveling endoscope
into a small intestine via the over tube according to the
embodiment of the present invention from an anus; and
FIG. 22 is a sixth view for explaining an action showing an example
of a technique for inserting the rotating self-traveling endoscope
into a small intestine via the over tube according to the
embodiment of the present invention from an anus.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
An embodiment of the present invention will be described referring
to FIGS. 1 to 22.
FIGS. 1 to 22 relate to an embodiment of a rotating self-traveling
endoscope system and an over tube of the present invention, in
which FIG. 1 is an entire block diagram illustrating the rotating
self-traveling endoscope system according to the present invention,
FIG. 2 is a perspective view illustrating a distal end portion of
an over-tube through which the rotating self-traveling endoscope is
inserted, FIG. 3 is a sectional view illustrating the distal end
portion of the over tube through which the rotating self-traveling
endoscope in the state of FIG. 2, FIG. 4 is a sectional view for
explaining a thrust generating cap disposed at the distal end
portion of the over-tube, FIG. 5 is a perspective view illustrating
the thrust generating cap, FIG. 6 is a perspective view
illustrating the thrust generating cap of a first variation, FIG. 7
is a perspective view illustrating the thrust generating cap of a
second variation, FIG. 8 is an entire block diagram illustrating a
rotating self-traveling endoscope showing a variation, FIG. 9 is a
plan view illustrating a length relation between the over tube and
a cover tube, FIGS. 10 to 16 are views for explaining an example of
a technique for inserting the over tube from an oral cavity and the
rotating self-traveling endoscope into a small intestine, and FIGS.
17 to 22 are views for explaining an example of a technique for
inserting the over tube from an anus and the rotating
self-traveling endoscope into the small intestine.
As shown in FIG. 1, the rotating self-traveling endoscope system
(hereinafter abbreviated as an endoscope system) 1 mainly comprises
a rotating self-traveling endoscope (hereinafter simply abbreviated
as an endoscope) 2, a control device 3, which is a camera control
unit (CCU), a monitor 4, and an over tube 5, which is a rotating
self-traveling endoscope insertion assisting tool.
The endoscope 2 mainly comprises a distal end portion 6, an
endoscope insertion portion 7, a housing case 8, and a rotating
driving device 9, which is rotating means.
The distal end portion 6 incorporates an image pickup unit, which
is image pickup means, not shown, inside. The image pickup unit is
provided with an objective optical system 29 and an illumination
optical system 30 (See FIG. 2 for both) exposed on the distal end
face of the distal end portion 6 and the surface positions are
flush with each other. At the position where photographing light
incident into the objective optical system 29 is collected, image
pickup device (not shown) such as CCD and CMOS are disposed.
An image signal photoelectrically converted by the image pickup
device is outputted to a board of the image pickup unit and
transmitted to the control device 3 through the rotating driving
device 9 via a communication cable inserted through the endoscope
insertion portion 7. At the illumination optical system 30, an LED,
which is a light source for radiating the illumination light to a
subject and is an illuminating member, is provided.
An endoscopic image photographed by the endoscope 2 is
image-processed by the control device 3 and displayed on the
monitor 4.
The endoscope insertion portion 7 of the present embodiment is a
flexible tube body in which a metal wire is helically and closely
wound so as to form projections and recesses to be a helical
structure in the helical state on the outer circumferential
surface. That is, the endoscope insertion portion 7 is a helical
tube, considering insertion performance into a body cavity, made of
a stainless steel, for example, and a predetermined diameter
dimension is set.
The endoscope insertion portion 7 is configured to be rotatable
around an axis in the insertion direction. Also, the endoscope
insertion portion 7 has its proximal end portion detachable to the
rotating driving device 9 by a connector 14. In the endoscope
insertion portion 7, the dimension of the projections and recesses
to be formed may be changed so as to set a pitch of the projections
and recesses and an angle of the helical in various ways.
In the rotating driving device 9, a motor 10 constituting a part of
rotating means and a rotating shaft body 13 detachably attached to
the endoscope insertion portion 7 by the connector 14 are
incorporated. A motor gear 11 of the motor 10 is engaged with a
gear 12 of the rotating shaft body 13.
The rotating shaft body 13 is rotated and held at the rotating
driving device 9, and a rotating driving force from the motor 10 is
transmitted. That is, by the rotating driving force transmitted to
the endoscope insertion portion 7, the endoscope insertion portion
7 is rotated around a long axis. And when the endoscope insertion
portion 7 is rotated, the helical structure with the projections
and recesses on the outer circumferential face is brought into
contact with an inner wall of the body cavity of a subject, from
which a thrust is generated, and the endoscope insertion portion 7
itself is going to advance in the insertion direction.
The endoscope insertion portion 7 is housed in the housing case 8
between the over tube 5 and the rotating driving device 9. The
housing case 8 is a hollow rectangular transparent or translucent
case body formed so that a rectangular closed space in the
thickness direction slightly larger than the diameter of the
endoscope insertion portion 7 is provided.
Opening portions 15, 16 through which the endoscope insertion
portion 7 is inserted are disposed on each of two side faces
constituting adjacent two sides of the housing case 8. The opening
portions 15, 16 are arranged respectively at an end portion in the
vicinity of a corner portion on the upper face of the housing case
8 where two side faces are adjacent to each other and an end
portion on the side face not located in the vicinity of the
opposing corner portion.
In the housing case 8 configured as above, the endoscope insertion
portion 7 is inserted from the opening portion 15 as an entrance
and guided out of the opening portion 16 as an exit. At this time,
the endoscope insertion portion 7 is housed in the meandering state
as shown in FIG. 1 within the housing case 8.
In this way, the housing case 8 housing the endoscope insertion
portion 7 can be configured so that the rotating lengthy endoscope
insertion portion 7 is not overlapped and mingled with each other
by twisting, and the endoscope insertion portion 7 can be protected
hygienically.
The above-mentioned over tube 5 comprises an insertion portion 20
and an operation portion 21. The insertion portion 20 has a
distal-end rigid portion 17 formed by a rigid member, a bending
portion 18, and a flexible tube 19 provided with predetermined
flexibility formed of a synthetic resin or the like in the order
from the distal end. The proximal end of the flexible tube 19 of
the insertion portion 20 is connected to a rigid bending stopper
portion 21a provided at the operation portion 21 in order to
prevent deformation by a rigid member.
In the operation portion 21, an endoscope insertion portion 22 to
be an insertion port of the endoscope insertion portion 7 of the
endoscope 2 on the side in the middle, two bending operation knobs
23, 24 for bending the bending portion 18 of the insertion portion
20 in four directions (up, down, right and left directions
corresponding to an endoscopic image captured by the endoscope 2),
a switch lever 25 for driving the rotating driving device 9,
switches 27 for various functional operations of the endoscope 2,
and switches 26 for operating an optical system such as various
photographing and illumination of the endoscope 2 are disposed.
The bending operation knobs 23, 24 are disposed on one side at the
proximal end side of the operation portion 21 so that the two knobs
in substantially the disk state are overlapped with each other.
These two knows are disposed rotatably and constituted by the
bending operation knob 23 for U (UP)/D (DOWN) for vertical
operation of the bending portion 18 on the side of the operation
portion 21 and the bending operation knob 24 for R (RIGHT)/L (LEFT)
for horizontal operation of the bending portion 18 on the U/D
bending operation knob 23.
In the present embodiment, the bending portion 18 is configured
capable of bending in the above four directions but may be
configured capable of bending at least in two directions.
From one side face of the operation portion 21, a universal cord
28, which is an electric cord, is extended. At an extended end of
the universal cord 28, a connector is disposed, and the connector
is detachably connected to the control device 3.
The control device 3 is electrically connected to the rotating
driving device 9 and controls the motor 10 on the basis of the
operation of the switch lever 25 of the over tube 5.
In the endoscope 2 in the present embodiment, a channel for
suction, air/water supply and treatment instrument insertion, not
shown, may be disposed at the insertion portion 20. An operation
required for the suction and air/water supply of the endoscope 2
can be carried out by switches 27 provided at the operation portion
21 of the over tube 5 in the present embodiment.
For the function of such suction and air/water supply, a water
supply tank, an air supply device such as a compressor and a
suctioning tool are provided at the control device 3. In the water
supply tank, sterilized water is reserved. When the air/water
supply button among the switches 27 of the operation portion 21 is
given a predetermined operation, the sterilized water is fed by the
control device 3 to a water supply tube disposed at the endoscope
insertion portion 7 of the endoscope 2 and injected from the distal
end portion 6.
At the endoscope insertion portion 7, an air supply tube is
disposed, and when a predetermined operation is given to the
air/water supply button among the switches 27 of the operation
portion 21, air is supplied from a compressor, not shown, in the
control device 3, and this air is injected from the distal end
portion 6 of the endoscope 2.
When the suction button among the switches 27 is operated, filthy
matters are suctioned from the distal end portion 6 of the
endoscope 2, and the filthy matters are fed into a suctioning
instrument from the control device 3 via a suction tube disposed in
the endoscope insertion portion 7. In the rotating self-traveling
endoscope 1, the suctioning instrument may be used or a suction
system installed at a hospital may be used.
To the control device 3, a foot switch capable of various
functional operations of the endoscope 2 may be connected through
an electric cable or the like.
Next, the distal end rigid portion 17 and the bending portion 18
constituting a part of the insertion portion 20 of the over tube 5
will be described using FIG. 3.
The distal end rigid portion 17 of the over tube 5 is substantially
in the rigid annular state formed by a synthetic resin with
biocompatibility and has a connecting ring 38 fitted in an inner
circumference portion on the proximal end side.
At the bending portion 18 of the over tube 5, a rigid distal end
bending piece 33 fitted at an proximal-end opening portion of the
distal end rigid portion 17 and a plurality of rigid bending pieces
37 (also called as bending node rings) are continuously provided
rotatably by a pivotally supporting portion 37a. The pieces 33, 37
are covered by a bending outer sheath 39 formed of an elastic
member such as a fluoro-rubber with biocompatibility. The distal
end portion of the bending outer sheath is fixed to the
proximal-end outer circumference portion of the distal end rigid
portion 17 by a reel bonding portion 31.
The plurality of bending pieces 37 have a wire guide 35 projecting
from the inner circumferential surface toward the center direction.
The wire guide 35 has a bending operation wire 36 (also called as
an angle wire) inserted therethrough.
There are four bending operation wires 36 in the bending portion 18
(only two of them are shown in FIG. 3), and a cylindrical locking
member 32 is fused by solder or the like at the distal end portion
of each. In the bending operation wires 36, the respective locking
members 32 are locked at four locking hole portions formed at the
distal end bending pieces 33.
The four locking hole portions are formed at positions equally
divided into four parts with substantially an equal interval on a
surface crossing the axis of the distal end bending pieces 33. The
positions around the axis of the distal end bending pieces 33 are
determined so that each of the locking hole portions is located in
correspondence with the up, down, right and left portions of the
endoscopic image. Therefore, the four bending operation wires 36
are held and fixed at four points separated with substantially an
equal interval in the vertical and horizontal directions.
Also, the bending operation wires 36 are inserted through the
insertion portion 20 of the over tube 5 and disposed up to the
operation portion 21. Each proximal end portion of the bending
operation wires 36 is connected to a bending mechanism portion, not
shown, interlocking with the bending operation knobs 23, 24 (See
FIG. 1) of the operation portion 21.
Therefore, when each of the four bending operation wires 44 is
pulled/loosened by the bending mechanism portion interlocking with
the bending operation knobs 23, 24, the plurality of bending pieces
37 are rotated in correspondence. Thus, the bending portion 18 is
bent and operated in the above-mentioned four directions.
At the proximal-end outer circumference portion of the connecting
ring 38 disposed in the above-mentioned distal end rigid portion
17, the distal end portion of an inner layer tube 34 is fixed. The
inner layer tube 34 has its proximal end portion connected to the
endoscope insertion portion 22 (See FIG. 1) of the operation
portion 21. The flexible tube 19 of the over tube 5 has a coil
sheath, not shown, through which each of the above-mentioned
bending operation wires 36 is inserted and the above-mentioned
inner layer tube 34 inserted.
In the over tube 5 configured as above, the endoscope insertion
portion 7 of the endoscope 2 is inserted from the endoscope
insertion portion 22 of the operation portion 21, and the distal
end portion 6 of the endoscope 2 is made capable of being guided
in/out through the opening portion of the distal end rigid portion
17 together with the endoscope insertion portion 7.
As shown in FIG. 4, it may be so configured that a cylindrical cap
state thrust generating member formed of an elastic member is
constructed at the distal end rigid portion 17 of the over tube 5
and a holding cap 40, which is the thrust generating cap, may be
provided.
The holding cap 40 has a hole portion 41 substantially at the
center of the distal end face and can be detachably inserted and
fixed by its elastic force to the distal end rigid portion 17 of
the over tube 5.
The hole portion 41 of the holding cap 40 has its hole diameter set
slightly smaller than the outer diameter of the endoscope insertion
portion 7 of the endoscope 2. Thus, the holding cap 40 brings the
endoscope insertion portion 7 of the endoscope 2 inserted through
the hold portion 41 into pressure contact for tightening and
assists generation of a thrust by rotation of the endoscope
insertion portion 7.
Also, since the endoscope 2 has its distal end portion 6 tightened
and fixed by the hole portion 41 of the holding cap 40, it is not
displaced at insertion of the over tube 5 into the body cavity.
Therefore, a user can insert the over tube 5 into the body cavity
while observing an endoscopic image of the endoscope 2.
Such a thrust generating portion assisting generation of a thrust
of the endoscope insertion portion 7 may be provided at the
endoscope insertion portion 22 of the operation portion 21 of the
over tube 5 but may be preferably provided at the distal end
portion of the over tube 5 with a high holding and fixing effect of
the endoscope 2 and the effect to apply a thrust.
Moreover, in the holding cap 40, instead of the hole portion 41 at
the center of the distal end face, a slit 42 as shown in FIG. 6 or
a cross slit 43 as shown in FIG. 7 may be provided.
Also, a protective tube 45, which is a protecting member as shown
in FIG. 8, may be provided over the endoscope insertion portion 7
of the endoscope 2 of the present embodiment.
More specifically, the protective tube 45 is provided with a
connection portion 45a to be detachably or integrally connected to
the opening portion 16 as an exit of the endoscope insertion
portion 7 of the housing case 8 at one end to be the proximal end
side. The protective tube 45 is formed of a flexible tube body
rotatably covering the endoscope insertion portion 7 by a
predetermined length from the housing case 8.
At the other end portion of the protective tube 45 to be the distal
end side, a member assisting generation of a thrust such as the
above-mentioned thrust generation portion may be provided at the
endoscope insertion portion 7.
The protective tube 45 is inserted from the endoscope insertion
portion 22 disposed at the operation portion 21 of the over tube 5
together with the endoscope insertion portion 7 from the operation
portion 21 of the over tube 5 to the flexible tube 19.
In order to explain the length relation in the longitudinal
direction between the over tube 5 and the protective tube 45,
suppose that a length from the distal end (distal end face of the
distal end rigid portion 17) of the over tube 5 to the proximal end
of the bending portion 18 is L1, a length of the above distal end
to the endoscope insertion portion 22 of the operation portion 21
is L2, and a length from the distal end of the protective tube 45
to the connection portion 45a is L3.
At this time, the length L2 from the distal end of the over tube 5
to the endoscope insertion portion 22 of the operation portion 21
is set longer than the length L3 from the distal end of the
protective tube 45 to the connection portion 45a (L2>L3). Also,
the length L2 is set longer than the length (L1+L3) obtained by
adding the length L1 from the distal end of the over tube 5 to the
proximal end of the bending portion 18 and the above length L3
together (L2>L1+L3).
By the relation among the above lengths (L1, L2, L3), the
protective tube 45 is set so as not to reach inside of the bending
portion 18 of the over tube 5. By this, the bending mobility of the
bending portion 18 of the over tube 5 is not undermined.
By providing the protective tube 45 covering the endoscope
insertion portion 7 in this way, the endoscope 2 can be configured
to prevent the inner layer tube 34 in the over tube 5 to be
inserted at rotation operation for generating a thrust by the
endoscope insertion portion 7 and the endoscope insertion portion
22 of the operation portion 21 from being damaged by the
rotation.
Next, two methods of insertion will be described using FIGS. 10 to
22 with regard to a case where the endoscope insertion portion 7 of
the rotating self-traveling endoscope system 1 configured as above
is approaching a small intestine via a gaster and a case where the
small intestine is approached from an anus via a colon.
First, an example of a technique for inserting the endoscope
insertion portion 7 of the endoscope 2 from an oral cavity to a
small intestine via a gaster by the rotating self-traveling
endoscope system 1 of the present embodiment will be described
using FIGS. 10 to 16.
First, a user inserts the insertion portion 20 of the over tube 5
from an oral cavity to a gaster via an esophagus 46 and bends the
bending portion 18 in the upper (UP) angle direction by the U/D
bending operation knob 23 of the operation portion 21 as shown in
FIG. 10. At this time, the endoscope insertion portion 7 of the
endoscope 2 has been inserted into the insertion portion 20 of the
over tube 5 in advance. When these operations are to be carried
out, the user performs the insertion operation of the insertion
portion 20 while observing an endoscopic image by locating the
distal end portion 6 of the endoscope 2 at the distal end rigid
portion 17 of the over tube 5.
Next, the user pushes in the insertion portion 20 by repeatedly
performing an angle operation of the bending portion 18 vertically
and horizontally by the bending operation knobs 23, 24 of the
operation portion 21 so that the distal end rigid portion 17
reaches the pyloric ring, which is an entrance to a duodenal cap
48, as shown in FIG. 11. During passage from the pyloric ring to
the duodenal cap 48, the user makes the angle of the bending
portion 18 neutral.
And when the distal end rigid portion 17 of the insertion portion
20 reaches the duodenal cap 48 as shown in FIG. 12, the user
operates the bending operation knobs 23, 24 of the operation
portion 21 while pushing in the insertion portion 20 so as to give
an angle to the bending portion 18 toward the descending leg of a
duodenum 49 as shown in FIG. 13.
Next, when the user pulls the insertion portion 20 of the over tube
5 while performing a twisting operation as shown in FIG. 14, the
insertion portion 20 is made straight. After that, the user rotates
the insertion portion 7 of the endoscope 2 in a predetermined
direction as shown in FIG. 15 by operating the switch lever 25 of
the operation portion 21 while the distal end side of the over tube
5 is inserted into the duodenum 49.
In this way, the endoscope insertion portion 7 of the endoscope 2
self-travels by generation of a thrust through contact between a
helical structure formed on the outer circumference portion and an
intestinal wall of the duodenum 48 and advances in the direction of
a deep portion of the small intestine 58 as shown in FIG. 16.
Moreover, the user can advance the distal end portion 6 of the
endoscope 2 into the deep portion of the small intestine 58 by
keeping on rotating the endoscope insertion portion 7.
Also, the user can retreat the endoscope insertion portion 7 in the
removal direction by reversing the rotating direction of the
endoscope insertion portion 7 inserted into the direction of the
deep portion of the small intestine 58 by operation of the switch
lever 25.
As having been described above, according to the rotating
self-traveling endoscope system 1 of the present embodiment, since
the rotating endoscope insertion portion 7 does not directly touch
organs from the throat of a patient to the esophagus 46 and the
gaster 47 by the insertion portion 20 of the over tube 5 at
insertion of the endoscope insertion portion 7 from the oral
cavity, a pain (burden) of the patient can be reduced.
Also, by this technique, the rotating self-traveling endoscope
system 1 can pass the insertion portion 20 of the over tube 5
through the gaster 47 having a large space and guide the endoscope
insertion portion 7 of the endoscope 2 to the duodenum 49.
Therefore, the user can easily insert the endoscope insertion
portion 7 to the deep portion of the small intestine 58 through
self-traveling by propelling action of the helical structure formed
on the outer circumference portion of the endoscope insertion
portion 7 by rotation on the intestinal wall of the duodenum 49 and
the small intestine 58 ahead of the duodenum.
Next, an example of the technique to insert the endoscope insertion
portion 7 of the endoscope 2 from an anus to the small intestine
via a colon by the rotating self-traveling endoscope system 1 of
the present embodiment will be described using FIGS. 17 to 22.
First, the user rotates the endoscope insertion portion 7 of the
endoscope 2 in a predetermined direction and passes the insertion
portion by propelling self-traveling generated by contact between
an intestinal wall of an anus 50 of a colon to a rectum 51, a
sigmoid colon 52, a descending colon 53, a transverse colon 54, and
an ascending colon 55 and the helical structure formed on the outer
circumference portion of the endoscope insertion portion 7 so as to
insert the distal end portion 6 into the vicinity of a cecum
56.
Then, the user inserts the insertion portion 20 of the over tube 5
along the endoscope insertion portion 7 to the vicinity of the
cecum 56 as shown in FIG. 18. After that, the user inserts the
distal end rigid portion 17 of the over tube 5 so as to pass the
Bauhin valve 57 by angle operation of the bending portion 18 of the
over tube 5 through the bending operation knobs 23, 24 of the
operation portion 21 as shown in FIG. 20 from the state in FIG. 19
while observing the position of the Bauhin valve 57 of an ileocecum
portion.
Then, the user surely inserts the distal end rigid portion 17 into
an ileum on the side of the small intestine 58 so as to pass the
Bauhin valve 57 by slightly returning the angle of the bending
portion 18 through the bending operation knobs 23, 24 of the
operation portion 21.
After that, the user rotates the insertion portion 7 of the
endoscope 2 in a predetermined direction as shown in FIG. 21 by
operation of the switch lever 25 of the operation portion 21 while
the distal end side of the over tube 5 is inserted in the Bauhin
valve 57.
By bring the helical structure formed on the outer circumference
portion in contact with the intestinal wall of the small intestine
58 in this way, the endoscope insertion portion 7 of the endoscope
2 self-travels by generation of a thrust and advances in the
direction of the deep portion of the small intestine 58 as shown in
FIG. 22. Moreover, the user can advance the distal end portion 6 of
the endoscope 2 into the deep portion of the small intestine 58 by
keeping on rotating the endoscope insertion portion 7.
Also, the user can retreat the endoscope insertion portion 7 in the
removal direction by reversing the rotating direction of the
endoscope insertion portion 7 inserted in the direction of the deep
portion of the small intestine 58 by operation of the switch lever
25 of the operation portion 21.
As described above, according to the rotating self-traveling
endoscope system 1 of the present embodiment, at insertion of the
endoscope insertion portion 7 from the anus 50 to the deep portion
of the small intestine 58 via the colon, the endoscope insertion
portion 7 can be easily passed through the Bauhin valve 57 at the
closed ileocecum portion to be a boundary portion between the ileum
and the colon as an exit of the small intestine, insertion through
which has been considered difficult.
As a result, the rotating self-traveling endoscope system 1 of the
present embodiment enables easy passage of the endoscope insertion
portion 7 propelling and self-traveling by rotation through a space
of a body cavity such as the gaster 47 and the Bauhin valve 57 of
the ileocecum portion and can improve insertion performance into
the small intestine 58, insertion through which has been thought to
be difficult, whether the approach is from the oral cavity or the
anus.
That is, in an endoscopic inspection, the flexible insertion
portion of the endoscope should be inserted through a long and
winding colon or a deep portion of a small intestine, and a skilled
technique is required for doctors. Particularly, the small
intestine exceeds 6 m in length and occupies approximately 80% of
the digestive tract and the small intestine is an important organ
for digestion and absorption. Therefore, for the small intestine,
early discovery of abnormality in an internal tissue is important.
The approach of the endoscope into the small intestine has a case
of insertion from the oral cavity via the gaster and a case of
insertion from the anus via the colon.
Then, the rotating self-traveling endoscope system 1 of the present
embodiment is capable of approach to the small intestine from the
oral cavity via the gaster, which has not been possible with the
conventional endoscope with the rotating insertion portion. Also,
the rotating self-traveling endoscope system 1 of the present
embodiment is configured to self-travel in contact beyond the
gaster to the entrance to the small intestine and further to the
intestinal wall of the duodenum at the deeper portion, not
requiring contact between the helical structure of the endoscope
insertion portion 7 and the gastric wall in the gaster having a
large space.
Also, the user as a doctor can easily pass the endoscope distal end
portion 6 through the Bauhin valve of the closed ileocecum portion
to be the exit of the small intestine and the boundary portion
between the ileum and the colon in the case of an approach of the
endoscope insertion portion 7 from the colon, using the rotating
self-traveling endoscope system 1 of the present embodiment.
Moreover, the endoscope insertion portion 7 of the present
embodiment should have some body to pass through a wide space such
as a gaster but does not have to rely on its own rigidity in the
gaster and is configured to have flexibility for self-traveling
propelling in the small intestine.
As described above, a rotating self-traveling endoscope system in
which the flexible endoscope insertion portion 7 which propels and
self-travels by rotation can easily pass the space in the body
cavity and a valve in the lumen, and a rotating self-traveling
endoscope insertion assisting tool and a method of technique for
inserting the endoscope insertion portion into the small intestine
by the rotating self-traveling endoscope system can be realized
particularly with an excellent insertion performance into the small
intestine.
The above described invention is not limited to each of the
embodiments but various variations can be put into practice in a
range not departing from its gist. Moreover, in each of the
embodiment, inventions at various stages are included and various
inventions can be extracted by appropriate combination in a
plurality of disclosed constituent features.
For example, even if some constituent features are deleted from all
the constituent features shown in each embodiment, the
configuration after the deletion of the constituent features can be
extracted as the invention, provided that the problem stated in the
problems to be solved by the invention can be obtained.
Having described the preferred embodiments of the invention
referring to the accompanying drawings, it should be understood
that the present invention is not limited to those precise
embodiments and various changes and modifications thereof could be
made by one skilled in the art without departing from the spirit or
scope of the invention as defined in the appended claims.
* * * * *